Up date. sexually transmission HPV HPV HPV. high-risk HPV HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 66, 68 HPV

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Transcription:

Up date Kei Kawana HPV HPV HPV HPV HPV6, 11 HPV HPV HPV vaccine preventable diseasevpd HPV HPV HPV DNA 8 HPV 100 genomic type HPV HPV HPV HPV HPV 1 sexually transmission HPV HPV 2 HPV high-riskhpv HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 66, 68 HPV low-riskhpv HPV6, 11, 42, 43, 44 1 HPV HPV 2 6 1 HPV 0113-8655 7-3 -1 Assistant Professor Department of Obstetrics and Gynecology, Faculty of Medicine (7-3-1 Hongo, Bunkyo-ku, Tokyo)

2 HPV611 HPV611 HPV VPD HPV intraepithelial lesion : IN 7, 8 HPV 7, 8 HPV HPV HPV HPV HPV 96, 93 HPV HPV 20,000 HPV 10,000 HPV 8 HPV 90 HPV1618 8 HPV HPV HPV1618 HPV HPV HPV1618 HPV1618 1, 9, 10 HPV1618 HPV1618 HPV1618 70 76 HPV1618 HPV HPV1618 HPV 30 HPV 11 HPV HPV HPV1618 HPV1618 HPV

HPV HPV1618 HPV 8 HPV1618 HPV HPV4 HPV VPD 3 10 20 5, 6 juvenile-onset recurrent respiratory papillomatosis : JORRP HPV611 HPV611 1 8 HPV-DNA HPV611 25 12 HPV611 4 411 36 16 4 HPV HPV 1.13 13 10 52 0.013 0.04 HPV 10 13 4 12 HPV611 JORRP JORRP 2 14 HPV611 JORRP

2,000 2,500 60 HPV 40 14 JORRP HPV HPV 611 JORRP 96 HPV11 14, 15 LASER JORRP 4 6 13 15 HPV HPV611 JORRP JORRP HPV VPD MerckMSD Glaxo Smith KlineGSK GSK Merck 2011 8 2 HPV HPV virus-like particle : VLP HPV HPV VLP HPV16, 18 VLP 2 16, 18, 6, 11 VLP 4 HPV HPV4 JORRP HPV 2 GSK AS04 10 HPV16, 18 0, 1, 6 3 4 MSD 9 HPV16, 18, 6, 11 0, 2, 6 3

HPV 16 9 26 HPV4 HPV 10 55 99 HPV 10 non-responder 15 26 1618 6111618 CIN2 100 21, 18 DNA per-protocol efficacy : PPE HPV PPE Intention-to-treatITT 50CIN2 HPV16, 18 HPV HPV HPV1618 20 30 HPV1618 80 90 HPV 20 30 5 80 HPV1618 HPV 7 9 HPV HPV 16 26 3 16, 17, 18 14 HPV-DNA 6111618 perprotocol efficacy : PPE PPE HPV6111618 CIN23, AIS, VIN23, VaIN23 100 4 HPV HPV HPV611 HPV1618 HPV HPV1618 15 25 1 vs 53 82 vs 174 Paavonen J, Lancet, 2009 HPV 16 26 0 vs 45 79 vs 168 Munoz N., JNCI, 2010

HPV6111618 PPE CIN23, AIS VIN23 VaIN23 ITT CIN23, AIS VIN23 VaIN2/3 16 26 3.5 4 n 7,864 7,900 7,900 4,689 8,823 8,956 8,956 8,689 cases 2 0 0 5 142 8 2 63 n 7,865 7,902 7,902 4,735 8,860 8,969 8,969 8,702 cases 110 13 10 140 293 30 14 305 95 93,100 67,100 55,100 91,99 40,60 40,89 38,98 73,85 < 4 HPV 20 intention-to-treat : ITT 50 ITT 80 2007 12 13 18 26 2 19, 20 STI 2007 28 4 14 HPV611 90 HPV4 HPV HPV

HPV 7 8 2 HPV 1 zur Hausen, H. Papillomavirus and cancer : from basic studies to clinical application. Nat Rev Cancer, : 342-350, 2002. 2 Insinga RP, Dasbach EJ, Elbasha EH, Epidemiologic natural history and clinical management of human papillomavirushpvdisease : a critical and systematic review of the literature in the development of an HPV dynamic transmission model, BMC Infect Dis, : 119-145, 2009. 3 Gissmann L, Wolnik L, Ikenberg H, et al., Human papillomavirus types 6 and 11 DNA sequences in genital and laryngeal papillomas and in some cervical cancers. Proc Natl Acad Sci USA, : 560-563, 1983. 4 3 5 IASR, : 239-241, 2008. 6 2001 : 147-167, 2002. 7 The current status of development of prophylactic vaccines against human papillomavirus infection. Report of a technical meeting. Geneva, 16-18 February, 1999. 8 Gillison ML, Chaturvedi AK, Lowy DR, HPV prophylactic vaccine and the potential prevention of noncervical cancers in both men and women, Cancer, : 3036-3046, 2008. 9 Bosch FX, et al.: Human papillomavirus and cervical cancerburden and assessment of causality. J Natl Cancer Inst Monogr, : 3-13, 2003. 10Vinokurova S, Wentzensen N, Kraus I, Klaes R, Driesch C, Melsheimer P, Kisseljov F, Dürst M, Schneider A, von Knebel Doeberitz M. Type-dependent integration frequency of human papillomavirus genomes in cervical lesions. Cancer Res, : 307-313, 2008. 11Kawana K, et al., Expression of CD1d and ligand-induced cytokine production are tissue-specific in mucosal epithelia of the human lower reproductive tract. Infect Immun, : 3011-3018, 2008. 12Mao C, et al. Clinical findings among young women with genital human papillomavirus infection. Am J Obstet Gynecol, : 677-684, 2003. 13Yamazaki T, et al., A study of abnormal cervical cytology in pregnant women, Arch Gynecol Obstet, : 355-359, 2006. 14Kimberlin DW : Current status of antiviral therapy for juvenile-onset recurrent respiratory papillomatosis. Antiviral Res : 141-151, 2004. 15Reeves WC. et al. Arch Otolaryngol Head Neck Surg. : 976-982, 2003. 16CDC, FDA licensure of quadrivalent HPV vaccinehpv4, Gardasilfor use in males and guidance from the ACIP, MMWR, 20, 2010. 17Kjaer SK, et al., A pooled analysis of continued prophylactic efficacy of quadrivalent human papillomavirustypes 6111618vaccine against high-grade cervical and external genital lesions, Cancer Prev Res, : 868-878, 2009. 18Muñoz N, et al.: Impact of Human papillomavirushpv- 6111618 vaccine on all HPV-associated genital diseases in young women. J Natl Cancer Inst : 325-339, 2010. 19Donovan B, et al., Quadrivalent human papillomavirus vaccination and trends in genital warts in Australia : analysis of national sentinel surveillance data, Lancet Infect Dis, E-pub, 2010. 20Fairley CK, et al., Rapid decline in presentations of genital warts after the implementation of a national quadrivalent human papillomavirus vaccination programme for young women. Sex Transm Infect, : 499-502, 2009. 21Paavonen J, Naud P, Salmerón J, Wheeler CM, Chow SN, Apter D, Kitchener H, Castellsague X, Teixeira JC, Skinner SR, Hedrick J, Jaisamrarn U, Limson G, Garland S, Szarewski A, Romanowski B, Aoki FY, Schwarz TF, Poppe WA, Bosch FX, Jenkins D, Hardt K, Zahaf T, Descamps D, Struyf F, Lehtinen M, Dubin G ; HPV PATRICIA Study Group, Greenacre M..: Efficacy of human papillomavirushpv-1618 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV typespatricia: Final analysis of a double-blind, randomised study in young women. Lancet, : 301-314, 2009.